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Stevens-Johnson Syndrome



Stevens-Johnson Syndrome (SJS) is a severe illness associated with fever, skin, and mucous membrane problems, including rash, blisters, and ulcers. Although it can affect skin all over the body, a trademark of SJS are problems of the skin inside the mouth, nose, and eyes.


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SJS is caused by an overreaction of the immune system to certain medications. It is not certain what causes the overreaction but it may be linked to genetic factors.

Risk Factors

Medications that are most often associated with SJS include:

  • Sulfonamides
  • Allopurinol
  • Aminopenicillins
  • Quinolones
  • Cephalosporins
  • Tetracyclines
  • Imidazole antifungals
  • Aromatic anticonvulsants

Other factors that may increase your chance of SJS include:


SJS symptoms progress over time. Early symptoms may include:

  • Fever
  • Sore throat
  • Cough
  • Burning eyes

After several days, the following symptoms may occur:

  • A red or purple rash that spreads
  • Swelling of the face and tongue
  • Skin pain
  • Blisters on the skin and the skin inside the mouth, nose, and eyes
  • Shedding of the skin


You will be asked about your symptoms and medical history. A physical exam will be done. This will often result in a diagnosis.

A sample of skin may be tested. This can be done with a biopsy.


Talk with your doctor about the best treatment plan for you. You may be referred to a specialist for treatment depending on your symptoms.

Treatment options include:


Your doctor may advise you to stop taking medications that may be causing the condition.

If not related to your symptoms, you may be given:

  • Pain medication to reduce discomfort
  • Antihistamines to reduce itching
  • Oral steroids or IV immunoglobulin (IVIG) to treat the disease
  • Lubricating or antibiotic eye drops
  • Antibiotics to treat an infection caused by bacteria

Fluid Replacement

You may be given IV fluids at the hospital to replace lost fluids.

Skin Treatments

Treatments for the skin may include:

  • Applying cool, wet compresses to blisters
  • Removing dead skin
  • Wound care


To help reduce your chance of getting SJS, avoid taking the medications that cause SJS to occur.


Johns Hopkins Medicine

Shriners Hospitals for Children

Canadian Resources:

Canadian Dermatology Association

Health Canada


Stevens-Johnson syndrome. Johns Hopkins Medicine website. Available at: Accessed December 12, 2017.

Stevens-Johnson syndrome. Patient UK website. Available at: Updated May 3, 2016. Accessed December 12, 2017.

Stevens-Johnson Syndrome/toxic epidermal necrolysis. EBSCO DynaMed Plus website. Available at: Updated September 7, 2017. Accessed December 12, 2017.

Last reviewed November 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 12/20/2014